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This interactive feature allows readers to decide on the diagnosis or management of a clinical case. A case vignette is followed by specific clinical options, none of which can be considered either correct or incorrect. Readers can participate in forming community opinion by choosing one of the options and, if they like, providing their reasons.

Read the Case Vignette and consider the Options for Care, then Vote and share your Comments.

Previous Volume 360:527-531 January 29, 2009 Number 5 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text Perspective by Drazen, J. M. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article by Kritek, P. A. PubMed Citation

Case Vignette

A 56-year-old homeless man was found having a seizure and was transported to the hospital. He was found to have a subarachnoid hemorrhage and acute hydrocephalus. He underwent intubation, and mechanical ventilation was started. A shunt was placed to relieve the hydrocephalus; cerebral angiography revealed a ruptured aneurysm of the anterior communicating cerebral artery and an unruptured aneurysm of the posterior cerebral artery. The patient had a score of 5 on the Glasgow Coma Scale. The neurosurgeon stated that without clipping of the aneurysm there was a 50% chance of recurrence of bleeding in the next 6 months, should the . . . [Full Text of this Article]

Options for Care

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This article has been cited by other articles:

• Kritek, P. A., Slutsky, A. S., Hudson, L. D. (2009). Care of an Unresponsive Patient with a Poor Prognosis -- Polling Results. NEJM 360: e15-e15 [Full Text]